In brief: Demo project, sequester cuts, Canadian market

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Friday, November 13, 2020

WASHINGTON – CMS will launch a demonstration project to allow nurse practitioners to certify that therapeutic shoes are necessary. 

Effective Jan. 1, 2021 -Dec. 31, 2025, beneficiaries with diabetes are eligible for the standard Medicare diabetic shoe and shoe inserts benefit if a nurse practitioner refers or certifies the beneficiary. Normally, these items are covered only if a physician refers or certifies. 

The benefit, including volume limits on supplies and billing requirements, is not changing in any way. 

CMS will launch the model in 26 regions: Alaska (statewide), Arkansas (statewide), California (statewide), Colorado (statewide), Delaware (statewide), Florida (statewide), Greater Buffalo region (New York), Greater Kansas City region (Kansas and Missouri), Greater Philadelphia region (Pennsylvania), Hawaii (statewide), Louisiana (statewide), Maine (statewide), Massachusetts (statewide), Michigan (statewide), Montana (statewide), Nebraska (statewide), New Hampshire (statewide), New Jersey (statewide), North Dakota (statewide), North Hudson-Capital region (New York), Ohio and Northern Kentucky region (statewide in Ohio and partial state in Kentucky), Oklahoma (statewide), Oregon (statewide), Rhode Island (statewide), Tennessee (statewide), and Virginia (statewide). 

Suppliers servicing beneficiaries in the 26 model demonstration regions should be alert to this information to ensure that documentation from nurse practitioners serving as certifying physicians for therapeutic shoes and inserts are participating in the demonstration project. Only nurse practitioners participating in the demonstration or are billing “incident to” a physician’s services are eligible to serve as the certifying physician for therapeutic shoes and shoe inserts. 

AAHomecare: Extend sequester cuts 

WASHINGTON - AAHomecare has joined a coalition of 27 major medical groups calling for Congress to extend relief for the duration of the COVID-19 public health emergency. 

Specifically, they are asking for the continuation of the suspension of 2% Medicare sequester cuts, which are scheduled to expire Dec. 31. 

AAHomecare is urging providers to share a letter asking their senators and representatives to continue this relief. 

Ascensia launches World Diabetes Day video campaign 

BASEL, Switzerland – Ascensia Diabetes Care is launching a series of videos in honor of World Diabetes Day 2020, Nov. 14. This year’s theme established by the International Diabetes Foundation, is Nurses Make the Difference. In the videos, people with diabetes write letters to their nurse expressing their appreciation for their guidance and support in managing diabetes. “According to the IDF, around 9% of the world’s adult population has diabetes, many of whom primarily self-manage their condition,” said Robert Schumm, president of Ascensia Diabetes Care. “Nurses are often the first and sometimes only health care professional that they see in their relation to diabetes. This reinforces the critical role they play and the positive impact they can have for a person with diabetes.” Ascensia is encouraging people to show support for World Diabetes Day and share, like or react to the videos on its social media channels. The videos are also available at www.ascensia.com/wdd2020/

Rehab Medical acquires Great Plains Medical 

INDIANAPOLIS – Rehab Medical has acquired Bixby, Okla.-based Great Plains Medical, a supplier of incontinence supplies through its ADvantage Program. The deal will further Rehab Medical’s plans to become a national supplier. Gail Sheets, CEO Of Great Plains Medical who recently retired, approached Rehab Medical, knowing the provider would provide great care to its members. “We are excited as a company to continue to provide the best-in-class service and medical products to the patients of Great Plains Medical,” said Business Unit Director Tri Van Le. “This acquisition is aligned with our immediate and long-term growth strategy to expand our company and brand nationally. We look forward to continuing utilizing our industry exclusive software technology and internal order processes to expedite orders and shipments to all our patients and improve their quality of life.” In October Rehab Medical expanded into Texas with its acquisition of San Antonio-based Wheelchairs Plus. 

DarioHealth sees 3Q revenues increase 

NEW YORK – DarioHealth reported revenues of $2.04 million for the quarter ended Sept. 30, 2020, an increase of 14.2% from the second quarter ended June 30, 2020. Gross profit was $549,000, a decrease of $324,000 or 37% from the previous quarter in 2019. The company said the decrease is a result of a decrease in the average selling price of its products. Total operating expenses for the quarter were $7.15 million, operating loss was $6.6 million, and net loss was $6.55 million. Highlights from the quarter include: a partnership with HMC Healthworks to extend DarioHealth’s reach to HMC’s more than 1 million members; and inclusion in Vitality's new Gateway Flex offering, allowing Dario's digital therapeutics platform to be marketed to Vitality's employer base that provides benefits solutions to 20 million people. 

NCPA: Community Rx vital in distributing COVID-19 vaccine 

ALEXANDRIA, Va. – The National Community Pharmacists Association welcomed the news that community pharmacies will be included in the network of health care providers approved to give COVID-19 vaccines. “Community pharmacies outnumber any of the largest chains, and they very often serve populations for whom there are no other accessible health care providers,” said NCPA CEO Douglas Hoey. “Defeating COVID-19 means relying on community pharmacies. Based on what we are hearing from our members and industry partners, the lead federal agencies see community pharmacy as a critical part of their plan for fighting the disease.” One major pharmaceutical manufacturer announced this week that its vaccine was highly effective in clinical tests. At least half a dozen other companies are expected to announce their results soon. 

Medela publishes peer-reviewed study of NPWT device 

MCHENRY, Ill. – Medela's Invia Liberty negative pressure wound therapy system is able to re-establish the prescribed pressure, while simultaneously clearing 89% of the fluid in less than 20 minutes, the manufacturer said in a peer-reviewed study published in a supplement to Wounds. Due to Invia's ability to remove exudate more efficiently and re-establish a patent system, it was also able to return the wound to the prescribed pressure more quickly and maintain the set pressure at the wound site more effectively. "The data demonstrates how important it is that NPWT systems are able to dynamically sense and respond to fluid volumes and viscosities as wound conditions change," said Rey Paglinawan, medical research manager for Medela. "Delivering set pressure to the wound bed and maintaining tubing that is patent and clear of fluid is essential for leveraging the full benefits of NPWT, critical for successful wound healing. This can only be realized with a proven and reliable system." Chronic wounds, including pressure injuries, diabetic foot ulcers and burns, cost an estimated $28 billion per year, according to Medela. 

People: 3B Medical, Soleo Health, Quantum Rehab 

3B Medical has named Katherine Royster as vice president of sales and marketing, where she will execute marketing and sales strategy and lead independent sales representatives in the U.S. Royster has more than two decades of experience in the sleep and respiratory industry, including senior marketing manager for oxygen therapy at Philips, where she was a member of the SimplyGo Mini launch team. “We are fortunate to have Katherine join the company’s senior leadership team as we continue to successfully launch new innovative products and expand our footprint into new markets for our three product lines of sleep, oxygen and disinfection,” said Dave MacDougall, COO…Soleo Health has appointed Elizabeth Feldman to the newly created role of vice president, business development and industry relations. In this role, Feldman will be responsible for developing and maintaining relationships with pharmaceutical manufacturers. Feldman has more than 15 years of experience working with pharmaceutical manufacturers to commercialize new products, most recently as vice president, specialty distribution for Two Labs Pharma Services. “We welcome Liz to the Soleo Health team,” said CEO Drew Walk. “We are confident the strong reputation she built within the specialty pharmaceutical industry and drug distribution network space will prove to be an asset to the company”...Quantum Rehab has promoted Dave Bertz to vice president, Quantum Sales – Western America. Bertz started his career at Quantum in 2015 as director, Quantum Sales – Western America. “Over the past five years, he has made a significant impact in the growth of Quantum and has grown personally as a professional,” the company stated. “Dave has demonstrated exceptional leadership, team building and customer relations skills. He has been instrumental in expanding our relationships with therapists in clinics and rehabilitation facilities, which are key sales generators.” Bertz has also worked to help build Stealth sales. 

CQRC ties COPD awareness with bid relief 

WASHINGTON – The Council for Quality Respiratory Care recognizes November as National COPD Awareness Month by commending CMS for its plans not to award competitive bidding contracts to 13 product categories, including oxygen supplies and equipment, in 2021. 

If finalized, the proposal would ensure that patients will be able to continue accessing oxygen supplies and equipment amid the COVID-19 pandemic, the CQRC says. 

“We applaud CMS for properly addressing policies that could have threatened patient access to home respiratory care,” said Crispin Teufel, chairman of the CQRC. “By excluding home respiratory care product categories in Round 2021 and extending the 50/50 blended rate (in rural areas), we are optimistic that COPD patients – and other seriously ill respiratory patients – can continue to receive uninterrupted access to care during this unprecedented pandemic and beyond.” 

CMS on Oct. 27 announced single payment amounts and began the contracting process for off-the-shelf knee and back braces, but not for the 13 other product categories. The agency also published a proposed rule that says it is considering extending the current fee schedule adjustments for non-bid and bid areas until new singe payment amounts are calculated when the bid program resumes.  

Canadian network of HME providers nears goal of 100 members 

TORONTO – The Ability Members Group has added 25 locations in 10 months, making it one of the fastest growing networks of HME providers in Canada, the company says. The growth spurt kicked off in January of this year, when Jamie Church, who has held senior  positions with Invacare Canada, McKesson Canada and Katz Group, was named CEO of the three-year old company. “Jamie’s extensive relationships in the home health care industry, along with his experience with business development and member support, have already proven to be a big benefit to our group,” said Stan Murray, president. Currently, the Ability Members Group’s national network of HME providers has 66 locations across British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, New Brunswick, Nova Scotia, Prince Edward Island and Yukon. Its goal: to have 100-plus members. 

HomesRenewed pushes for tax incentives for aging in place 

WASHINGTON – The HomesRenewed Coalition is calling on the 117th Congress to include tax and other incentives in legislation in 2021 to allow Americans to upgrade their homes for safety and to meet changing needs, as well as to help the economy with construction jobs. “This is a quickly moving group effort bringing together builders and remodelers, manufacturers and distributors, as well as health care providers to ensure that our aging population’s housing needs are understood and addressed in upcoming legislation,” said Louis Tenenbaum, founder and CEO of HomesRenewed Coalition. “Research shows that 80% of Americans want to age in place. This is the perfect story: COVID-19 laid bare the dangers of living in long-term group care facilities; jobs are needed; and health care costs are going through the roof. But safe and appropriate housing just isn’t available today. We need government incentives to drive consumers to upgrade their homes now.” HomesRenewed Coalition is mobilizing the leaders of the home renovation, home care, technology and other segments serving older Americans. Major supports of the campaign include VGM Live at Home, Lifewise Clinical Home Modifications, Accessible Systems, HandyPro, Age Safe America and Legal Eagle Contractors. 

TiLite awarded certification 

LEBANON, Tenn. – Permobil’s manual wheelchair unit, TiLite, has been awarded ISO 13485:2016 certification for product design, development, manufacturing and distribution of its medical device products. “Permobil has created high quality, user-focused medical devices for decades,” said Chuck Witkowski, president of Permobil Americas. “We are passionate about creating our products with the highest standards for safety, performance and reliability that not just meet, but exceed, our end users’ expectations. I want to thank our team for their hard work and commitment in receiving this important certification.” The certification is an internationally recognized standard for quality management systems. It demonstrates an organization’s ability to provide medical devices that consistently meet customer expectations and regulatory requirements. Permobil notes that the U.S. Food and Drug Administration announced last year that it intends to harmonize and modernize their Quality Systems Regulation (QSR) for medical devices by transitioning to ISO 13485:2016 for its audit inspections. 

CMS announces slight increase for Medicare Part B premiums 

WASHINGTON – The standard monthly premium for Medicare Part B enrollees will be $148.50 in 2021, an increase of $3.90 from 2020, CMS has announced. 

The annual deductible for Medicare Part B beneficiaries will be $203 in 2021, an increase of $5 from 2020. 

Previously, in September, CMS announced that the average monthly premium for Medicare Advantage is expected to decrease 11% to $21 in 2021. 

“With the 2021 Medicare Part B premium information now available, I encourage everyone with Medicare to take time over the next four weeks to review their options during Medicare Open Enrollment,” said CMS Administrator Seema Verma. “Thanks to President Trump’s leadership, Medicare Part B premiums remain steady and seniors have more plans than ever to choose from, many new benefits and historically low Medicare Advantage and Part D premiums.” 

Medicare Open Enrollment started on Oct. 15 and runs through Dec. 7. 

CMS says Medicare spending is estimated to grow in 2021 due to people seeking care they have delayed during the COVID-19 public health emergency, availability of more COVID-19 treatments and availability of COVID-19 vaccines. 

AAH roundup: Proposed rule, Stand Up, TRICARE 

AAHomecare has published key takeaways from CMS’s recent proposed rule outlining changes to the fee schedule methodology starting April 1, 2021, or immediately after the public health emergency, whichever is later…AAHomecare’s Stand Up for Homecare, held during last week’s Medtrade Virtual Conference, raised $6,500 toward the association’s commitment to support ITEM Coalition. The coalition is a policy steering group for more than 80 patient advocacy organizations that have been strong allies on HME policy priorities…AAHomecare has asked the assistant secretary of defense for health affairs to direct TRICARE West contractor Health Net Federal Services to automatically reprocess claims to reflect rates granted by provisions in the CARES Act retroactive to March 6, 2020. The association is asking suppliers serving these beneficiaries to also contact the Defense Health Agency. 

NRRTS honors registrants, announces new program and partnership 

LUBBOCK, Texas  – NRRTS presented its Distinguished Service Award to Tom Simon, ATP, CRTS, of Numotion, and its Simon Margolis Fellowship to Mike Barner, ATP, CRTS, of the University of Michigan Wheelchair Seating Service, and Weesie Walker, ATP/SMS of NRRTS, during the organization’s first virtual Annual Open Meeting on Oct. 28. “I first met Simon Margolis at the Seating Symposium in Memphis,” said Walker, executive director of NRRTS. “His vision of an organization that gave seating and mobility suppliers an identity was a game changer. He inspired us to be every mindful of NRRTS’s place in the CRT industry. By holding registrants to a standard of practice, he knew that consumers were likely to get a better outcome.” About 100 people tuned in to the meeting. NRRTS also announced its Complex Rehab Technology Supplier Program, which will launch by the end of the year with its first course, and a new partnership with the Canadian Assistive Device Association. 

NCART pushes telehealth for PTs, OTs 

EAST AMHERST, N.Y. – NCART has responded to CMS’s proposed rule on Medicare payment policies for physicians, which includes proposals related to continuing the expanded telehealth policies when the public health emergency expires, but not for physical and occupational therapists. NCART has written a letter to CMS in support of permanently authorizing PTs and OTs as telehealth practitioners and including the related PT and OT codes as authorized telehealth services. Additionally, NCART is also continuing to hold discussions with congressional offices regarding the importance of a permanent telehealth option, how it applies to people with disabilities who require CRT and the need for legislation to give CMS the authority to take the necessary actions.